Management of Pericardial Effusion
 
For purposes of this survey, assume that you are asked to consult on a hospitalized middle aged patient who has been diagnosed with stage IV non-small cell lung cancer. The patient has shortness of breath in the absence of an important pleural effusion. There is no endobronchial obstruction and there is no evidence for pulmonary embolism. A CT scan demonstrates a pericardial effusion. Although echocardiography demonstrates a large pericardial effusion with no evidence for tamponade, there is some mild diastolic collapse.
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1. Do you manage patients with pericardial effusion?

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2. Do you believe definitive management of this effusion is appropriate?

3. In your institution, which treatment option is most commonly used first?

4. What is your preferred method for surgically managing this effusion?

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5. If you manage such patients with a pericardiotomy, do you perform sclerosis as well?

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6. Does the degree of symptoms reported by the patient influence your choice of surgical intervention for such effusions?

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7. In what region is your surgical practice based?